We are facing an extraordinary hyper-epidemic that simply cannot be defeated with orthodox thinking. For over a century, addressing TB in mining has been deemed an “urgent necessity” or “a matter of grave concern.” Given the Ministers’ personal dedication, this issue is becoming less about complicity and more about fighting a battle we can’t win using the inadequate tools and policies we have today. The research community must work to aggressively design, validate, and implement novel, industry-specific interventions and programs for miners and ex-miners. Innovation beyond the industry’s traditional purview is also necessary – one is correct to question the feasibility of achieving zero TB deaths in the mines this decade without a vaccine or novel drug therapies. The government and industry have their own role to play in overcoming the epidemic, but they only follow the path our data take them. If we lead with ingenuity, they will follow.

Jonathan Smith is a lecturer in Epidemiology of Microbial Diseases and Global Health at Yale University School of Public Health, where he researches TB and HIV in the context of mining in sub-Saharan Africa. He is an affiliate of the Yale Global Health Leadership Institute and Founding Director of Visual Epidemiology, a non-profit organization seeking to combine academic data and discourse with personal narratives through film making.